Leverage and Other Change Strategies

The article (Leverage Part 1) below explains how we modify the highly successful pilot/physician recovery programs to apply to other groups, with an emphasis on affluent addicted and dysfunctional family members. The other article (Leverage First) discusses tools for using family resources as a positive influence for recovery.

For pilots and physicians, maintaining their license to fly or practice medicine is an obvious incentive to comply with treatment recommendations.  For others, the task is to find something similar in their lives that they value, such as access to funds, resources, employment, relationships or status.  We find this process – the use of pressure or therapeutic leverage – can be a very effective tool to encourage compliance with treatment recommendations during and after in-patient treatment. Click “Download” to read more.

The issue of Hazelden Voice below looks further into the pilot program and its success (92% at two years). This success can be attributed to the HIMS Program as well as the rigorous drug testing implemented. From the article:

the good news is that pilots who complete a prescribed and comprehensive rehabilitation program have achieved high rates of recovery. According to professionals in the field, about 92-95 % of pilots who go through an extensive rehabilitation process – called the Human Intervention and Motivation System (HIMS) remain sober two years later.

There are five basic steps in the HIMS Program

1.  Identification of the chemically dependent pilot

2. Evaluation for Chemical Dependency

3. Primary Treatment

4. Aftercare

5. Continuing Support and Monitoring (drug tests)

The leverage to obtain treatment compliance is the license to practice medicine or approval to fly. Read more:

Case management and family monitoring offer another useful strategy in creating leverage:

Below is an example of a return to work agreement. Agreements such as these are vital when we are requiring people to comply with treatment in order to maintain employment. They need to be straight forward and lay out clear expectations for the recovering addict.

If you need guidance for building leverage into governance docs, see below my article download titled “Leverage and Docs”.